腹腔镜子宫肌瘤剔除术中子宫动脉阻断对卵巢功能及妊娠的影响

Effect of Uterine Artery Occlusion on Ovarian Function and Pregnancy during Laparoscopic Hysteromyomectomy

目的探讨腹腔镜下子宫肌瘤剔除术中行子宫动脉阻断术对卵巢功能及妊娠率的影响。方法子宫肌瘤患者120例,按随机数字表法分为研究组和对照组,每组60例,研究组在腹腔镜子宫肌瘤剔除术中行子宫动脉阻断,对照组仅行腹腔镜子宫肌瘤剔除术,不阻断子宫动脉。对比两组卵巢功能、促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E2)、窦状卵泡(AFC)数及妊娠状况。结果研究组术中出血量少于对照组,手术时间短于对照组(P<0.05)。术后6个月,两组患者FSH、LH、FSH/LH、E2、AFC水平差异无统计学意义(P>0.05);术后研究组卵巢储备功能下降比例为10.00%,对照组为11.67%,两组比较,差异无统计学意义(P>0.05)。术后随访2年,研究组有生育要求者妊娠率36.11%(13/36),对照组为40.48%(17/42),两组妊娠率比较差异无统计学意义(P>0.05)。结论腹腔镜下子宫肌瘤剔除术中行子宫动脉阻断术对卵巢功能及妊娠率无明显影响。

Objective To investigate the effect of uterine artery occlusion on ovarian function and pregnancy rate during laparoscopic hysteromyomectomy .Methods One hundred and twenty patients with hysteromyoma were randomly divided into study group and control group according to the random number table ,with 60 cases in each group .The study group received uterine artery occlusion during laparoscopic hysteromyomectomy , while the controls received laparoscopic hysteromyomectomy alone without uterine artery occlusion .The ovarian function,follicle-stimulating hormone（FSH）, luteinizing hormone（LH）,estradiol（E2）,antral follicles（AFC） and pregnant status of two groups were compared. Results The amount of bleeding in the study group was less than that in the control group ,the operation time was shorter than that in the control group（P〈0.05）.There were no significant differences in the levels of FSH,LH,FSH/LH, E2 ,AFC six months after operation between two groups （P〉0.05）.The postoperative ovarian function declined by 10.00%in the study group and by 11.67%in the control group ,there was no significant difference between two groups （ P〉0.05） . All the patients were followed up for 2 years ,the pregnancy rate of patients who had fertility requirements in the study group was 36.11%（13/36）,while in the control group was 40.48%（17/42）,there was no significant difference in the pregnancy rate between two groups （P〉0.05）.Conclusion There is no significant effect of uterine artery occlusion on ovarian function and pregnancy rate during laparoscopic hysteromyomectomy .